Surgery Godfather
Chapter 824 - 738: Decoration? Ceremony?

Chapter 824: Chapter 738: Decoration? Ceremony?

A set of foraminotomy scopes, a set of arthroscopes, and two sets of laparoscopic equipment were connected properly and ready for use in surgery at any moment.

This was neither an arthroscopic surgery nor a foraminotomy surgery, but rather a craniovertebral junction surgery. Yet, Yang Ping had brought in two sets of laparoscopic equipment.

Not only did August not understand, but so too were Song Zimo and Xu Zhiliang puzzled. During the preoperative discussion, it had only been mentioned that the anterior approach through the mouth required endoscopic assistance, after all, the mouth and pharynx had natural cavities with a certain operating space suitable for endoscopic or laparoscopic manipulation.

Regarding posterior surgery, however, there was no mention of using laparoscopy. There was no natural cavity from the posterior approach, not even a potential one. How could a lens be inserted? How could surgery be performed under the scope?

Yang Ping didn’t notice everyone’s confusion; he simply started the surgery on his own.

Performing the posterior surgery in a sitting position posed great challenges, both in terms of surgical field visibility and operative space, particularly since the front pathway had already fixed the skull base and cervical spine, preventing the opening of the space between vertebrae plates by flexing the neck. These disadvantages were further magnified, but Yang Ping had his own methods.

He combined the arthroscope and the foraminotomy scope, two types of endoscopic systems, to serve as his tools for obtaining a field of view. He intended to perform a laparoscopic surgery within an open surgery, abandoning the inertia of using direct vision with the naked eye, and relying on the thinking of laparoscopic surgery, he planned to complete the posterior surgery with a well-practiced hand-eye coordination.

Yang Ping personally adjusted the focus and exposure for both the arthroscope and the foraminotomy scope, and then the surgery began. He made a vertical incision on the back of the neck and occipital area.

This was completely the routine of open surgery!

August was puzzled and couldn’t help feeling somewhat disappointed. He had thought Yang Ping would use minimally invasive surgery to tackle the posterior approach. But then, upon reflection, he realized that at this moment, the minimally invasive method clearly was impractical. How could it possibly be done with minimally invasive techniques?

Under laparoscopic minimally invasive conditions, how could such large internal fixation devices be implanted? How could bone grafting be done? How could screws be driven? These operations had to be performed in an open space, and all the instruments were traditional ones.

No matter how skilled a doctor is, they are human, not divine. Every operation must be completed within the limits of human capability.

The skin, subcutaneous tissue, fascia, and muscle were cut layer by layer, all the way to the skull base and cervical spine’s vertebrae plate, and then the soft tissues on both sides of the skin and the vertebrae plate were prised apart, below the base of the skull and against the vertebrae plate.

"Set up the screens symmetrically, with the arthroscope on the right side and the foraminotomy scope on the left side. Get the hooks ready," Yang Ping instructed.

The two hook-holding experts would normally take their places promptly without needing Yang Ping to speak up, but the sudden appearance of the laparoscopic equipment also stunned the hook-holding experts for a moment as they racked their brains, trying to understand what was going on.

The Instrumental Nurse, Xiao Su, immediately pointed with her hemostat to the positions of the hook-holding assistants. The two experts then snapped out of their surprise and hurriedly headed to the front line.

August was still pondering the issue. Since it was open surgery, what was the use of the arthroscope and foraminotomy scope?

Decoration? Does surgery need decoration? Or was it some sort of ritual by the professor?

If it were his free time, August would definitely persist in asking until he got an answer, but as it was during surgery, he couldn’t ask. He could only continue to observe the operation.

At this point, the two hook-holding experts came into action. They positioned themselves on each side, each holding a hook firmly, steadily drawing open the incision to reveal the surgical area.

These were not ordinary hook wielders; they were world-class hook-holding experts.

Their upcoming monumental work, "Surgical Hook Science," would be a groundbreaking textbook, filling a void in such specialized literature. Most importantly, it would feature an array of hooks in all shapes and varieties, many of which were the first of their kind in the world.

The two hook-holding experts were calm and composed, breathing steadily, their hooks not trembling in the slightest. This was not something an ordinary person could achieve. To attain this level of proficiency, the two experts had invested immense effort.

They trained their arm strength every day and also practiced their breathing to coordinate it with their movements.

To become a hook-holding expert, however, this was not nearly enough. They delved into the study of anatomy; with each hook placement, they had to be familiar with the local anatomy of the location and also understand the characteristics of those tissues. They studied the science of vision to discover the best methods for maximizing visibility with the hooks.

Thus, the masterpieces of the two great experts were imbued with their painstaking efforts, covering a profound depth and breadth—Surgical Hook Anatomy, Surgical Hook Visiology, and Surgical Hook Positioning—

With two surgical hooks revealing the surgical area, Yang Ping inserted the arthroscope and the foraminotomy endoscope into the operative field, one above the other, the foraminotomy endoscope on top, the arthroscope on the bottom; two screens immediately displayed the images of the operative area, with the left showing the upper part and the right showing the lower part.

Yang Ping adjusted the two scopes, and each of the two hook experts used their other hand to steady a scope, leaving them with no free hand—one holding a hook, the other holding a scope.

Looking at this setup, were these two endoscopes really about to come into play?

August racked his brain at full speed, wondering what was being planned. It was supposed to be an open surgery, yet two scopes were inserted inside, as if setting up for minimally invasive surgery. The incision was clearly open, so why insert two scopes?

Could it be that the scopes were merely for show? Or part of some ritual?

August turned his head to look at Robert, hoping this guy could provide an explanation, but he seemed just as confused.

Never mind, how could a sports medicine doctor understand the spine better than he did? August gave up on seeking Robert’s guidance. He was going to ask, but seeing Yang Ping so intently focused, he didn’t dare to disturb, not even Song Zimo, so August continued to observe.

After all, at least the professor was currently lucid, all actions rational. Keep watching, and the answer would come.

The next steps in the procedure had everyone’s eyes widen in amazement.

For conventional open surgery, due to exposure and operational difficulties, an endoscope was used for assistance. Yang Ping didn’t need to look at the surgical area but instead at the images on the screens, employing hand-eye coordination techniques to complete this cranial base upper cervical spine surgery.

Damn!

Robert couldn’t find the right words and resorted to this unrefined and rough expression to describe his feelings.

Damn!

At a loss for words, August could only follow Robert’s lead.

It was simply brilliant. Who knew surgery could be done this way, using endoscopes like this? The hand-eye coordination technique for endoscopic operation was simply at the pinnacle of perfection.

With the aid of the endoscope, the difficulties of surgical field visibility and operative space were effortlessly resolved. Every corner that the camera lens could see became clearly visible, countless times better than the human eye.

Yang Ping alternated his gaze between the left and right screens, because the left displayed the upper half of the operative field, while the right showed the lower half. Only by combining these two parts could he see the complete operative area.

Guided by this split real-time imaging, Yang Ping began his skillful hand-eye coordination operation under the endoscope.

The resection of the posterior arch of the atlas, the posterior halves of the lateral masses, the clearance of hematoma within the vertebral canal, incision of the spinal cord’s dura mater, and removal of the subdural hematoma were all performed to decompress the spinal cord sufficiently. Every step of what would typically be an open surgery was, today, completed under the scope.

Song Zimo and Xu Zhiliang, serving as assistants, were naturally sidelined, becoming close-range observers on the platform. They couldn’t achieve such proficient hand-eye coordination and rely solely on the screens to assist in the entire surgery. Hence, the surgery became a solo performance by Yang Ping. At that moment, the two hook experts concentrated intently, maintaining the entire surgical field with two ordinary hooks, like sculptures, while both scopes remained just as still.

The further August watched, the more he realized that this method of surgery greatly improved precision over direct-eye surgery because the camera magnified the operative site many times, and the entire field of surgery was visible under the scope, with no blind spots. There was no need to adjust the hooks or positioning to get a view of any corner.

Again, August was stumped. Yang Ping wasn’t operating under a single screen but under two split screens offering divided views. In addition to high-level hand-eye coordination skills, he also had to mentally combine the two screens into one.

The difficulty of synchronizing hand-eye-brain for this task was beyond August’s description.